TickBorne Disease Connecting animals people and their environment

Tick-Borne Disease Connecting animals, people and their environment, through education

What is a zoonotic disease? ● an animal disease that can be transmitted to humans (syn: zoonosis) ● dictionary. reference. com/browse/zoonotic+disea se

Terms to know: What are ticks? Ectoparasite: An organism that attaches to the outside of a host and feeds on that host (example: ticks feed on host’s blood. ) (Compared to an endoparasite which lives inside a host’s body. ) ● Arachnids (related to spiders) ● Slow-crawling, wingless ectoparasites Vector: Species that carry and spread disease to other organisms. ● Vectors, transmitting pathogens that cause disease as they Host: The organism that the vector/parasite is attached to / feeding on. feed ● Ticks aren’t natural reservoirs of disease, but pick diseases up * Reservoir Host: diseases Species that agent & acts (most tick-borne arecommonly bacterial)carry fromthe thedisease first host as a potential the disease. (Often rodent or small bird in they feed on –source often of a mouse or small birda or rodent. the case of white-footed tick-borne diseases. ) (Especially mice) ● Disease is then passed to hostfeeding #2 (fed on byfor thethe nymph * Incidental Host: Not a on preferred species parasite, but stage) or host #3 (fed on by the adult tick) (* Larvae do occasionally will be fed upon if it happens to come in contact not with transmit disease as they. Deer have not fed on anything to pick up the parasite. (Example, are preferred hosts for Black-legged aand pathogen yet. ) Lone Star ticks, however humans are often incidental hosts. )

Tick life cycle Ticks have 4 life stages: * egg * six-legged larva * eight-legged nymph * adult Image courtesy CDC, http: //www. cdc. gov/ticks/life_cycle_and_hosts. html After hatching from the eggs, ticks must eat blood at every stage to survive. Ticks can take up to 3 years to complete their full life cycle, and most will die because they don't find a host for their next feeding.

How Ticks Find Hosts *Ticks can detect animals´ breath and body odors, and sense body heat, moisture, and vibrations. Ticks can't fly or jump. They wait for a host, resting on the tips of grasses and shrubs in a position known as "questing". * When a host brushes the spot where a tick is waiting, it quickly climbs aboard. * Some ticks attach quickly; others will wander before attaching. Image courtesy CDC / James Gathany (image #7663)

Ticks in Kansas: in order of abundance ● American Dog Tick (Dermacentor variabilis) ● Black-legged / Deer Tick (Ixodes scapularis) ● Lone Star Tick (Amblyomma americanum) ● Brown Dog Tick (Rhipicephalus sanguineus)

● American Dog Tick (Dermacentor variabilis) Transmits: Rocky Mountain Spotted Fever and Tularemia Larva Nymph (Photo courtesy www. tickencounter. org) Male Female Fully-fed

● Black-legged / Deer Tick (Ixodes scapularis) Transmits: Lyme Disease, Human Babesiosis, and Human Anaplasmosis Larva Nymph Male (Photo courtesy www. tickencounter. org) Female Fully-fed

● Lone Star Tick (Amblyomma americanum) Transmits: Human Ehrlichiosis, Tularemia, STARI, and Heartland Virus Larva Nymph (Photo courtesy of www. tickencounter. org) Male Female Fully-fed

● Brown Dog Tick (Rhipicephalus sanguineus) Transmits: Mostly only causes disease in dogs. Occasionally transmits RMSF to humans (along USMexico border and in SW US). Larva Nymph (Photo courtesy www. tickencounter. org) Male Female Fully-fed

● Bacterial Tularemia ● Sudden fever & chills ● Headaches, muscle aches & stiff joints ● Diarrhea, weakness & dry cough Figure 1: Distribution of Tularemia (Image courtesy of CDC, http: //www. cdc. gov/tularemia/statistics/map. html) Figure 2: Micrograph of Francisella tularensi (Image courtesy of NIAID Laboratory of Intracellular Parasites, Tularemia Pathogenesis Section) Figure 3: Skin lesion of Tularemia. (Image courtesy of CDC / Emory Univ. ; Dr. Sellers. PHIL #1344)

● Bacterial Lyme Disease ● Flu-like symptoms ● Stiff neck ● Fatigue and headache ● Muscle ache & joint pain Figure 1: Distribution of Lyme disease in US (2012) (Image courtesy of CDC, http: //www. cdc. gov/lyme/stats/maps/inter activemaps. html) Figure 2: Micrograph of Borrelia burgdorferi, Figure 3: Bull’s eye rash characteristic of Lyme disease. the agent of Lyme disease. (Image courtesy of CDC. PHIL #6631 ) (Image courtesy of CDC / James Gathany. PHIL #9874)

● Parasitic protozoan Babesiosis ● Infects red blood cells ● Flu-like symptoms ● Can cause hemolytic anemia (destruction of red blood cells) Figure 2: Micrograph of Giema-stained thin blood Figure 1: Distribution of Babesiosis. Notice there smear showing Babesia organisms sequestered in are no reported cases in KS. (Image courtesy of erythrocytes. (Image courtesy of CDC, http: //www. cdc. gov/parasites/babesiosis/datastatistics. html) http: //www. cdc. gov/dpdx/babesiosis/gallery. html#thin blood. MO 1) Figure 3: Skin rash associated with of Babesiosis (Image courtesy http: //phil. cdc. gov/phil/home. asp)

● Bacterial Anaplasmosis/Ehrlichiosis ● Fever, chills, headache ● Muscle pain ● Nausea and fatigue ● Rarely, rash Figure 1: Distribution of Ehrlichiosis/Anaplasmosis (Image courtesy of KDHE http: //www. kdheks. gov/) Figure 2: Micrograph of Anaplasma phagocytophilum (Image courtesy http: //wwwnc. cdc. gov/eid/article/20/10/13 -1680 -f 2 http: //commons. wikimedia. org/wiki/File: Echaff. jpg

● Unknown Southern Tick Associated Rash Illness (STARI) Researchers once hypothesized that STARI was caused by a spirochete, Borrelia lonestari, further research did not support this. ● Headache & fever ● Fatigue ● Muscle pain ● Similar to Lyme Disease but less intense symptoms Figure 1 & 2 (right): STARI rashes take many forms. (Image courtesy of CDC, http: //www. cdc. gov/stari/sy mptoms/)

● Viral Heartland Virus ● Fever, fatigue and headaches ● Diarrhea ● Loss of appetite ● Most require hospitalization (no cure) Figure 1: Distribution of Heartland Virus (named after Heartland Medical Center)

Rocky Mountain Spotted Fever Figure 1: Distribution of RMSF in KS. (map courtesy of KDHE, kdheks. gov) ● Fever, nausea & vomiting ● Headache, muscle pain ● Significant tiredness ● Loss of appetite Figure 2: This micrograph shows intracellular Figure 3: The characteristic spotted rash of Rocky Mountain spotted fever bacteria, Rocky Mountain spotted fever Rickettsia rickettsii. (Image courtesy CDC/ Billie (Image courtesy of CDC phil. ID #1962) Ruth Bird)

Canine Tick-Borne Disease Agents in the U. S. ● Lyme disease (Lyme borreliosis) ● Borrelia burgdorferi ● Ehrlichiosis/Anaplasmosis ● E. canis, E. ewingii, E. chaffeensis ● A. phagocytophilum, A. platys ● Rocky Mountain spotted fever ● Rickettsia ricketsii ● Babesiosis ● B. canis, B. gibsoni ● Canine hepatozoonosis ● Hepatozoan americanum, Hepatozoan canis

Possible Canine Symptoms ● ● Lethargy May/may not have fever Often have respiratory disease Central nervous system signsseizures, vestibular problems (balance) Photo by swong 95765 on flickr. com ● Low platelet count ● Symptoms for many tick-borne diseases are very similar “Tick-borne Diseases: Rocky Mountain Spotted Fever” with Dr. Kate Ku. Kunach (Stenske) Significance: Pets are often sentinels for human disease. A pet illness may indicate a potential concern for their owners. Sentinel: to provide a guard for something or for a group of people

Diagnosing Tick-Borne Disease Clinical Diagnostic criteria include: ● history of tick bite normally found ● Endemic: residence in (or recent travel to) disease-endemic region or native to, a region ● patient symptoms ● laboratory confirmation of patient exposure to pathogen in,

General Symptoms of Tick-Borne Disease ● Flu-like (fever, headache, fatigue, myalgia) ● Rash ● Lyme and STARI – erythema migrans (bull’s eye rash, photo right) ● RMSF (see photo below, right) Exceptions: ● Tularemia – fever, signs depend on route of entry ● Babesiosis – includes anemia; may recur months later ● Tick Paralysis – ascending paralysis Images courtesy of CDC http: //www. cdc. gov/lyme/signs_symptoms/index. html

Laboratory confirmation Indirect evidence of infection ● Measures patient antibody response to pathogen Western blot, ELISA, IFA ● Positive result indicates patient exposure to pathogen Sample Western Blot. Lighted bands indicate positive results. http: //commons. wikimedia. org/wiki/File: Anti-lipoic_acid_immunoblot. png Sample ELISA results. Darker colors indicate higher patient titers*. http: //commons. wikimedia. org/wiki/File: ELISA. jpg

Laboratory Confirmation cont. ● Direct evidence of infection Measures presence of pathogen in patient samples (e. g. staining, live culture, PCR) Sample PCR results. Lighter bands indicate positive results. Photo by US Fish and Wildlife Services, Pacific Region Instance ID xmp. iid: 32 EC 3399 D 85 C 11 E 287 C 88492 1347 FB 51

Prevention: Humans ● Repel from skin using DEET (at least 20% concentration) ● Wear light colored clothing ● Treat gear and clothing with permethrin (withstands washing several times) ● Cover legs, ankles and feet (tuck pants into socks) ● Walk in the center of trails ● Check for ticks within 2 hrs when coming indoors / shower. Include check of gear to prevent later attachment. Check for ticks in these areas http: //www. cdc. gov/ticks/resources/Hu nterfactsheet. pdf

Prevention: Humans ● Tumble clothes in the dryer to kill remaining ticks (High heat) ● Remove any ticks using tweezers close to tick’s mouth, gently with upward pull (no twisting ● After removal, clean the area with rubbing alcohol, iodine scrub or soap and water ● Do not crush (spread pathogens by aerosolizing) or flush ticks (can crawl out and lay eggs on back of toilet) Image courtesy of CDC, http: //www. cdc. gov/ticks/removing_a_tick. html Do NOT put anything on the tick to make it let go as that will make it purge what it has eaten into you, which increases chance of infection.

Prevention: Pets and Property For pets, use repelling chemicals: treated collars, topical medications to prevent attachment ● Check pets for ticks regularly ● Treat with chemicals to kill ticks already attached OR remove carefully by avoiding twisting action (and safe disposal method) ● In backyards, clip tall grass (sunlight causes desiccation) ● Spring burning reduces populations (temporarily) ● Use chemical pesticides in problem areas (shaded areas and kennels)-- sprays and granules usually professionally applied. ● Top photo, by Dave Conner Photo on left by Michael Coté

Tick Bite Prevention Video (Youtube) https: //www. youtube. com/watch? v=m 2 av. Emm. Le. EA

Ticks and Ecology Connection The abundance and distribution of Ixodes scapularis (Black-legged tick) and Amblyomma americanum (Lone Star tick) have increased and spread along with the white-tailed deer population. ● Estimated 90% of adult ticks of these two species feed on deer ● Deer are the key to the tick’s reproductive success!

Increased Tick Encounters ● ● ● Reforestation Wildlife conservation, relocation, and restocking Climate fluctuations Migratory Birds Decreased environmental pesticide application Increased human contact with natural areas (recreation, occupation, housing into forests) ● Decreased predator populations (especially predators of small rodents)

References Images: Tick life Cycle (n. d. ) [chart] Retrieved from: www. cdc. gov/ticks Ticks (n. d. ) [photograph] Retrieved from: www. cdc. gov/ticks Kansas map (n. d. ) [map] Retrieved from: http: //www. kdheks. gov/bephi/index. html Micrograph (n. d. ) [photo] Retrieved from: http: //phil. cdc. gov/phil/home. asp Distribution of Tuleremia (2012) [photo] Retrieved from www. cdc. gov/tuleremia Tularemia symptoms (n. d. )[photograph] Retrieved from: http: //www. columbia-lyme. org/patients/tbd_tularemia. html Stari Symptoms (n. d. ) [photograph] Retrieved from: http: //www. cdc. gov/stari/symptoms/ Distribution of Lyme Disease (2012) [photo] Retrieved from http: //www. cdc. gov/lyme/ PCR: Image from Embers, M. E. , Barthold S. W. , et. al. (2012) Persistence of Borrelia burgdorferi in Rhesus Macaques following Antibiotic Treatment of Disseminated Infection. Plos. One. (7) 1. Retrieved from http: //www. plosone. org/article/info%3 Adoi%2 F 10. 1371%2 Fjournal. pone. 0029914 Video: BADA, UK. (2013, March 13) Tackling Ticks - Tick Bite Prevention Week 2013 [Video File] Retrieved from https: //www. youtube. com/watch? v=m 2 av. Emm. Le. EA